Activity Based Funding (ABF) / Healthcare Pricing Office (HPO)

Brian DonovanBrian Donovan, Interim Head, Activity Based Funding (ABF) / Healthcare Pricing Office (HPO)

The Healthcare Pricing Office (HPO) plays a central role in providing leadership for and management of activity based funding (ABF). This is a funding model for hospital care for inpatient and day-case services. This means a specified price is paid to each hospital for each weighted unit of inpatient work and each weighted unit of day-case work.

The HPO sets the national Diagnosis Related Group (DRG) prices on which the ABF system is based and is a strategic driver for change. Underpinning this, the HPO is responsible for a range of central ABF functions.

Services provided by the team include:

Activity Based Funding

Developing the annual price list for hospital services.

Ownership, management and quality assurance of the national Hospital In-Patient Enquiry (HIPE) dataset with appropriate data governance.

On-going development of the HIPE classification system and coding standards.

Training, education and support of clinical coders nationally, and supporting hospitals to undertake their own local workforce development.

Working with hospitals on coding audits and data quality reviews.

On-going development and maintenance of costing standards and audit against the standards.

Speciality and patient-level costing for price-setting, including development of patient-level costing software.

Supporting hospitals and Hospital Groups / regional health bodies to use their own ABF data to better understand activity and opportunities for improvement.

Developing classifications and price-setting capability for other care streams, including outpatient care, emergency care and (as a new function from 2020/2021) for costing community healthcare.

Consulting with clinicians, system managers and other stakeholders across the hospital system.

Managing oversight and specialist reference groups.

National Perinatal Reporting System (NPRS)

Managing the National Perinatal Reporting System (NPRS) which collects national statistics on perinatal events.